Organization
DIABETES AMERICA LLC
Active
Other names
MedEase RX Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
TAMMIE MISKIMINS (MGR. LICENSING & THIRD PARTY)
(817) 572-0009
Entity
Organization
Contact information
Practice address
4519 MATLOCK RD STE 135A, ARLINGTON, TX 76018-5674
(817) 855-1035
Mailing address
1620 W. NORTHWEST HWY, SUITE 100, GRAPEVINE, TX 76051
(817) 572-0009
(817) 720-1039
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
29636
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2149257
PK
—
Enumeration date
12/15/2014
Last updated
06/28/2016
About Stedi
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